Summary

Nasogastric tube placement is a common procedure performed in surgical and medical specialities. The occurrence of knot formation
is perhaps one of the least well-recognised complications associated with its usage. We present a case of nasogastric tube
knotting to remind colleagues of this rare but important complication. A 75-year-old woman with adhesional bowel obstruction
was admitted under the general surgery team. A wide bore nasogastric tube was inserted for drainage and decompression. Although
placement of the tube was deemed to be successful, there was no drainage of gastric content evident. On removal of the ‘non-functioning’
tube a simple knot was seen at its proximal end. A further nasogastric tube was placed and the patient’s symptoms resolved
with conservative management. Nasogastric tube knotting is a rare and often overlooked complication with the potential to
cause significant trauma on tube removal if unrecognised.

Footnotes

Contributors VC: Senior house officer looking after patient on ward, planning of case report, acquisition of images and patient consent,
literature review, write up of article and submission of article. TA : Registrar looking after patient on ward, liaising with
radiologist and review of CT images, review of case report and amendments to content/structure. JF: Registrar looking after
patient on ward, review of case report and amendments to content/structure. LN: Review of article and amendments to content/structure,
reformatting and review of CT images. SE-R: Consultant in charge of patient care, final review and amendments to article.